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Best ssri for anxiety/panic disorder?


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30 replies to this topic

#1 americandancer

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Posted 14 July 2006 - 08:53 AM

Which has been proven to help better with anxiety/panic - zoloft or lexapro? I know meds effect everyone differently, but I can't seem to find out which one is preferred more. It seems like the lexapro, but my doctor really likes zoloft for anxiety.

#2 Jkm

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Posted 14 July 2006 - 08:55 AM

I was on Lexapro and it took 7mo. for it to cover the anxiety without the help of a small dose of Ativan, but I know plenty of people in real life who are on Zoloft for depression and anxiety and they never had to have anything else with it.

I forgot to tell you that I was dx.d with panic disorder and depression. It's a difficult illness to have when it get going full force. It's been a couple of years and never have the symptoms come back, so I think it's safe to say that Lexapro, then Cymbalta have worked for me.

Edited by Jkm, 14 July 2006 - 09:03 AM.

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I have GAD. I worry about everything, lol!

#3 americandancer

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Posted 14 July 2006 - 11:50 AM

Are you just on cymbalta for the anxiety? I like the cymbalta okay. If I knew the anxiety was going to go away, and it's not going to always be "revving" me up, I'd stay on it. I've just read so much that norephinephrine is not the best for anxiety sufferers. I can understand why you take it with the neuropathy, but I'm just taking it for anxiety/panic.

#4 Dooin' it

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Posted 14 July 2006 - 12:13 PM

It's probably a toss up.

My mother, sister and myself (I'm male) all share similar symptoms. We go into "episodes" of depression/anxiety and have used different meds to help.

I was on Celexa (best, I think of any SSRI out there) and was switched by my pdoc to Lexapro due to a generic vs. name-brand issue he felt was important.

My sister and mother are both currently on Zoloft and have been for several years now. My sister thinks it's great. My mother thinks it's "good" but not as good as she's been on other meds. (She's been on a proverbial "rainbow" of meds over the years).

Anyway............suffice to say, I think they're both similar. If you reeeeeeally wanna nail your pdoc down to why he favors Zoloft for you, just ask. You could even start with........."Do you prefer Zoloft period?? Or do you just prefer Zoloft for me??"

Then you can go into the *why*. And I'd make him explain to you what Zoloft would do for you that Lexapro couldn't, etc. In a nutshell, you want to find out what his *protocol* and/or *criteria* are for suggesting one drug over the other to you. (And even though I'd concede that Zoloft is probably just as good as Lexapro, I'd still push him for the *why* part just so you could have some peace of mind. Might as well make these shrinks work for their money 'cuz they certainly get paid A LOT of it!!!!!!!!!!!) :hearts:

Prayers & thoughts ~ Randy
Isaiah 54:17a "No weapon forged against you will succeed;"

I Peter 5: 6,7 "Humble yourselves, therefore, under the mighty hand of God, that he may lift you up in due time. Cast all your anxiety upon Him for he cares for you."

Recommended reading........"Feeling Good; The New Mood Therapy" by Dr. David Burns

#5 americandancer

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Posted 14 July 2006 - 12:16 PM

Thanks, Randy, for your response. I need to clarify one thing here. My gp is the one who prefers zoloft. I am not presently seeing a pdoc. I have seen a psychologist in the past for my anxiety issues for cbt. I have not seen a psychiatrist. Does that matter? I feel I suffer mainly anxiety, panic disorder, depression, and pmdd, in that order.

#6 Dooin' it

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Posted 14 July 2006 - 12:26 PM

OK, that's still fine................(Ultimately, I wonder how much of a difference there is sometimes).

I was originally put on Celexa back in '98 by my GP. He had an intern who had just returned from a seminar on depression and was very eager to put her to work on my case. He also seemed to know a great deal about depression himself. I think my GP is a very knowledgable doctor.

But, of course, I was recommended to a psychiatrist by my medical group, so I definitely took taht opportunity as he does do a little more listening, diagnosing, evaluatin, etc. I also think he's VERY knowledgable. He studies endlessly and tries very hard to diagnose properly! He was the first one to explain to me how he literally uses a very structured protocol for figuring out what someone might need, including what they've taken in the past and how things have changed for them over the years. (He's good about tha stuff).

So, you should probably do the same thing for your GP as well!! Just press him/her on the *why* and see what they say. It may be just because they've seen more good results with Zoloft than anything else. And, again, I don't know if Zoloft isn't just as good or even better than lexapro. Sure, Lexapro's website will tell you it's the #1 prescribed SSRI in the country, but that doesn't mean it's the best. And that definitely doesn't mean it's the best *for you*!!!

Again, I think it's probably a coin toss, to be totally honest. If my sister loves Zoloft that much, I'm certainly happen to endorse it on her behalf. And I can attest to Celexa/Lexapro. They're both good drugs, and both seem to work on depression *and* anxiety so either way you go, you *should* get relief!!
Isaiah 54:17a "No weapon forged against you will succeed;"

I Peter 5: 6,7 "Humble yourselves, therefore, under the mighty hand of God, that he may lift you up in due time. Cast all your anxiety upon Him for he cares for you."

Recommended reading........"Feeling Good; The New Mood Therapy" by Dr. David Burns

#7 americandancer

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Posted 14 July 2006 - 02:22 PM

I agree....zoloft may work well for your sister while lex is good for you. I just hate to have to go through another 2 months trying one or the other to see which one I need. At least I have them both, so I can try the lex and give it a fair shot, and then try the z after that. I've used both before. The zoloft was okay for me, but a little stimulating. Exactly the way the cymbalta is doing me now. I just wish they'd make an anti-depressant that could work exactly like xanax! At least for us anxiety sufferers! I just want to cry, not because I'm depressed, but because I am so, so tired of anxiety, shaking, panic attacks, irritability! I can't stand it and I just don't know what to do. Thank God for boards like this one.

#8 Dooin' it

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Posted 14 July 2006 - 04:50 PM

Honestly, if you felt like the Zoloft was a little too stimulating for you, I'd probably recommend Lexapro!


It will probably take a full 6 weeks, but I know that it's roots in Celexa definitely give it the edge for anxiety over depression. Yes, Zoloft seems to work well on depression too, but I think Zoloft is targeted more toward depression while Lexapro can be taken for strictly anxiety alone........(or again, at least that's been its reputation).

Since you already know what Zoloft can do for you, I'd probably go that route. Just keep an eye on the side effects & make sure you're tolerating them OK. Also, I'd probably start out at 10mg right away & see how you're doing on that. 10mg can be a very therapeutic dose. Get in a full 4 weeks at 10mg before changing anything.

Again, not gospel, just my .02!
Isaiah 54:17a "No weapon forged against you will succeed;"

I Peter 5: 6,7 "Humble yourselves, therefore, under the mighty hand of God, that he may lift you up in due time. Cast all your anxiety upon Him for he cares for you."

Recommended reading........"Feeling Good; The New Mood Therapy" by Dr. David Burns

#9 americandancer

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Posted 14 July 2006 - 04:51 PM

OMG, yall are going to think I'm really crazy, but I broke down and took my cymbalta this afternoon. I had missed the last two days because I was planning on starting zoloft or lexapro, and guess what? I was in tears this afternoon, at my wits end, and now I feel great! I guess that's my cue to stay on the cymbalta and don't mess a good thing up. I'll give it a few more weeks to see if I start getting the nervous energy again, but I feel so much better right now. It's kinda scary.
:hearts:

#10 Jkm

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Posted 14 July 2006 - 05:15 PM

Sounds like you found a winner, americandancer!! That blah feeling is really bad, isn't it? I take it mainly for the anxiety and the pain disorder and lastly the depression, which I think comes from dealing with the other two, or not dealing well with the other two. I take the neurontin and my legs have been cramping up real bad the last couple of days; worse than in a long time. :bump: (I also have restless leg syndrome.) I guess my legs are shot! No reason for this, either. No bloodclots...... Had things checked. The doc couldn't find any reason for it.

Jackie :hearts:
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I have GAD. I worry about everything, lol!

#11 americandancer

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Posted 14 July 2006 - 05:47 PM

Randy, we must have been posting at the same time, because I just saw your reply. I agree that I will start at the 10mg, if I switch. I have 20mg, so I'll just cut them in half. That's what I did last time I tried it. When do you take yours? AM or PM? I'm sure it's somewhere on here, just thought I'd ask you personally. You've are a great help! Thanks for being there! I was majorly freaked earlier today! I may switch just because of how bad I've been acting the last two days from not taking the cymbalta!
Jackie, that's interesting you take if for anxiety also. I knew you said you had neuropathy, so I can see why he gave it to you for that. I hope it continues working for you....That blah feeling was bad, and really scary. Not to mention, my kids saw me like that, and I got pretty irritable! I hate being that way. Angry one second, crying the next. I've got to do something to get ahold of myself. I may just try lexapro just to see....maybe I was going through w/d earlier? I don't know... :hearts:

#12 americandancer

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Posted 15 July 2006 - 10:16 AM

Spoke too soon. Turned back into my irritable, crying, anxious self last night. Hubby and I had an argument. Took a xanax and went to bed. Now, how do I get through today without losing my sanity????

#13 Jkm

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Posted 16 July 2006 - 07:22 AM

If you have a period of time during the day that you feel well, the meds are probably working to some extent. i had this when I first started meds and it got longer as the says went by until after a couple of weeks, I felt pretty good.

Just keep taking your meds. The problems with ad's is that they take so long to work. Maybe 4 to 6 weeks till the mood lifting effects start. This is usually why docs will give you a script for anxiety meds like Xanax. I used Ativan to get through this and treat the anxiety symptoms.

Sorry that you're having crying spells. I hope this passes soon. I'm sure your hubby is feeling helpless in what to do to calm you down.

Is anything going on that you need to unload? Any idea where the anxiety is coming from?

Jackie :hearts:
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I have GAD. I worry about everything, lol!

#14 americandancer

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Posted 16 July 2006 - 08:42 AM

Thanks, Jackie. I don't think there's one thing in particular. I honestly think I felt that way because I skipped those two days. It wasn't even close to that time of the month for me!!! lol I wonder if splitting the dose of cymbalta into the am and afternoon would help that feeling. But, like you said it could just go away with time. I really like the cymbalta for the energy and the fact that it seems to help the anxiety and the crying spells, but I still don't like the "revved" up feeling. I mean, it makes my hands shake and all. Do you think that will go away with time? That's why I was considering changing to lex. I go back to work in a few weeks (teacher) and I really want to be better by then. I guess I could continue taking the cymbalta for the next four weeks or so, and then tell my dr. if it's still making me nervous. I guess that would be the smart thing to do. I can't tell you how much this board has helped me this week! You all are great! :hearts:

#15 Jkm

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Posted 16 July 2006 - 09:27 AM

Exactly what meds are you taking? Maybe something is causing this revvedup feeling. I had Panic disorder and that was horrible, but never the revved up feeling from Cymbalta. Wish I did! I'd rev up and do some heavy cleaning, like wash the walls down, lol! I get my kitchen floor washed real fast if I get angry about something. I guess I just use some of these creepy emptional states in a different way until it dissapates.

Jackie :hearts:
Posted Image

I have GAD. I worry about everything, lol!

#16 americandancer

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Posted 16 July 2006 - 10:20 AM

Right now, I'm taking cymbalta and alprazolam, as needed. I do have more energy when I take the cymbalta, so I can clean up, etc. I actually focus on what I'm trying to accomplish, also. The only down side is it makes me shaky. When I go out in public, I feel like everyone can see my hands shaking. I have a harder time talking to people, if that makes sense. I just don't get a "calm" feeling from the c, like I do an alprazolam. I think it's the norephinephrine (sp?) making me like that, even though I know cymbalta is supposed to help anxiety! If it would go away for sure, I would wait it out. I just don't know if it will. The last time I took it was for 7 weeks, and the feeling didn't go away. It should have by then, shouldn't it? :hearts:

#17 Dooin' it

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Posted 16 July 2006 - 11:54 AM

Ya, it probably should've in that span of time, but there are never guarantees with these meds either.

I'd say, the first thing would be that regardless of what you're anticipating doing, definitely stay on your meds and keep taking them at regular intervals. Keep as much stability in your med dosages as possible!!


And in answer to your Lexapro dosage timing..........I take mine in the morning. No particular reason, just always have & it's worked for me so I just keep it at that. Some folks who have issues with the side effects will take it at night, but for me morning works.

And I don't know that your doc might not have you *transition* thru meds if necessary.

I tapered off of Celexa at the same time I started taking Lexapro. Now,they are sister drugs, but that was still a lot of med goin' thru my system 'til I was off the Celexa and my doc seemed perfectly confident in that method.

Prayers & thoughts ~ Randy
Isaiah 54:17a "No weapon forged against you will succeed;"

I Peter 5: 6,7 "Humble yourselves, therefore, under the mighty hand of God, that he may lift you up in due time. Cast all your anxiety upon Him for he cares for you."

Recommended reading........"Feeling Good; The New Mood Therapy" by Dr. David Burns

#18 moiraine

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Posted 16 July 2006 - 06:55 PM

Hi Americandancer,
I am bipolar and so take medication for that problem. But I have xanax around for when I have a panic attack, which doesn't happen too often. But when it does, it feels like someone has their hands around my throat and squeezing so I can't breathe. I am gasping for breath and it is very scary. The xanax I have is .5mgs. Half of that puts me to sleep. So I would take 1/4 of that .5mgs tablet and after a while I would calm down enough and breathe normally again. Many people don't like to take Xanax because they say it is habit-forming. But I think because I take a lot of other medications as well, my tolerance for it is very low. I only get panic attacks when I am very upset, like if I get in a fight with someone, or get very worked up over something. That is my story, but maybe your doctor might think differently for you, as everyone reacts differently to medications. Good luck in finding a med that works for you, take care :hearts:
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Posted Image Our hearts grow tender with childhood memories and love of kindred, and we are better throughout the year for having, in spirit, become a child again at Christmas-time. - Laura Ingalls Wilder

#19 americandancer

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Posted 16 July 2006 - 08:56 PM

Thanks everyone! You all are so great here. I agree I have to stay on my meds and stop switching around.
moiraine, I hear you about the panic attacks. The last few days, I've taken my alprazolam when I felt like I absolutely had to, and it felt pretty good. Today, I actually took one before things got out of hand, and I felt so much better. I mean, I felt normal....like I think I'm supposed to really feel.

Edited by americandancer, 16 July 2006 - 08:57 PM.


#20 Rowan

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Posted 19 July 2006 - 03:28 PM

Thanks everyone! You all are so great here. I agree I have to stay on my meds and stop switching around.
moiraine, I hear you about the panic attacks. The last few days, I've taken my alprazolam when I felt like I absolutely had to, and it felt pretty good. Today, I actually took one before things got out of hand, and I felt so much better. I mean, I felt normal....like I think I'm supposed to really feel.



I'm a new member to the site - well, I was here 4 years ago for about a year, but I signed up with a new account because I couldn't remember my old user information. I was on Paxil for a year and put on 40 pounds, so I stopped taking it. I was fine for about 3 years, then after Katrina I've been on a downward spiral into anxiety and now depression as well. I went for my annual checkup with my GP yesterday and she prescriped Lexapro. I took one yesterday evening and an hour later I literally passed out for two hours. Is this normal? I'm going to start taking it at bedtime and see how that goes. Hope it works for the anxiety - I can't take much more at this point.

Susan

#21 americandancer

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Posted 19 July 2006 - 04:12 PM

Hi Susan! What mg. lexapro are you starting on? It's better to start small and work your way up. My doctor always told me to take it in the evening, because it can make you sleepy. Good luck with it! Hang in there, because side effects will go away with time. It is supposed to be good for anxiety.

#22 Rowan

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Posted 19 July 2006 - 04:21 PM

Hi Susan! What mg. lexapro are you starting on? It's better to start small and work your way up. My doctor always told me to take it in the evening, because it can make you sleepy. Good luck with it! Hang in there, because side effects will go away with time. It is supposed to be good for anxiety.



I started at 10 and my GP said to call her in a month and she will up it to 20 mg if the 10 isn't doing it for me. She gave me 4 weeks worth of samples and I already filled a 30 day prescription, so I think I will actually take all 60 of the 10 mg before making a decision about dosage. I'd obviously rather take 10 if I can get by with 10 - but after 8 weeks I (and my husband) should definitely know for sure whether 10 mg if sufficient.

#23 americandancer

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Posted 19 July 2006 - 04:33 PM

You might want to 1/2 the 10mgs into 5mgs for a few days to a week and then up to 10mgs, if you feel like it knocks you out again.

#24 Rowan

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Posted 19 July 2006 - 05:25 PM

You might want to 1/2 the 10mgs into 5mgs for a few days to a week and then up to 10mgs, if you feel like it knocks you out again.


Thanks for the suggestion. I may take the 10 mg again today and see what happens. If it really messes me up I'll split them and try 5mg a day for a week.

#25 Jkm

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Posted 19 July 2006 - 05:44 PM

Rowan,

When I went on ad's this last time, I had depression and panic disorder and the doc started me at 5mg. of Lexparo for 5 days, then I took 10. Unless you're switching ad's, I know the smaller dose is best to start with. I also took the Lexparo when I went to bed and it helped me stay asleep.

I can't imagine taking it when I woke up, but worked with a gal who did. How she stayed awake was beyond me, lol!

americandancer,

Don't wait till you're stressed out and suffering with the anxiety to use the other med. If your anxiety is high, use it to keep youself relaxed, dear! I know what anxiety was like for me to deal with every day. A little ativan got me to work and back and kept me from having anxiety attacks while I was driving to and fro. It enabled me to go back to work and probably kept me out of the hospital.

Jackie :hearts:
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I have GAD. I worry about everything, lol!

#26 SchroedingersCat

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Posted 24 July 2006 - 07:45 PM

So, I am someone who suffers from severe panic attacks and a constantly elevated state of anxiety. I am also Bipolar I with psychotic features and I absolutely can not take SSRIs as they will put me into mania bigtime within a week of starting to take them. I had to learn that lesson the hard way. Benzos like Klonopin, Ativan, Xanax, etc. are also off-limits to me due to my history of substance abuse. The pdoc has offered them to me and I have politely declined. He understands why.

So, instead of SSRIs and benzos, I take an extra 300 mg Seroquel if I feel an attack coming on. I already take 1200 mg/day of the Seroquel, an anti-psychotic med, but I take it all at night because the side-effects are so debilitating, sleepiness mostly. When I say sleepiness, I'm talking about comatose. Even if I take just 300 during the day, I'm pretty much non-functional.

Anyhow, I thought I'd just chime in and offer a perspective from someone who can't take SSRIs or benzos and has to deal with the attacks another way.
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#27 americandancer

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Posted 24 July 2006 - 08:27 PM

I don't know much about seroquel, but thank you, sc. I'll keep that in mind if things get worse. I don't know if I could handle "comatose" right now, lol. Glad it's working for you!

#28 SchroedingersCat

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Posted 25 July 2006 - 11:35 AM

LOL at comatose. And this is once you get used to it. When I first started taking Seroquel, I slept around the clock for several weeks.
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#29 the bitter truth

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Posted 29 July 2006 - 10:40 PM

hey guys, first time I've signed up for a forum like this. Zoloft actually made me sick, but obviously it's very individualized... I use prozac now and whether it's working or not, I don't know.

#30 DaKrazy1

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Posted 04 August 2006 - 07:42 AM

For me neither of them helped. I can't say if one was better or worse then the other. Well, actually they both helped somewhat with my anxiety, but I still needed klonopin to cope. As far as helping with the depression they did nothing. But remember, it all depends on the person.

#31 tiredofpanic50

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Posted 07 April 2008 - 09:16 PM

Oh I am so relieved to find this site. I have had depression and panic all my life. I take Zoloft 50 MG and 1MG of Clonazapam at bedtime. This has helped me for the longest time. Even when my son went to Iraq last year. Now I have just gotten over being very ill with Diverticulitis and antibiotic related C-Diff. I was in the hospital a week and I am doing everything to make myself better. I had to take Flagyl for two weeks and I think it may have interferred with my meds? Have you ever heard of that? I am having panic attacks alot now. I really need an antidepressant that addresses anxiety first. I have that worse than depression. I saw that you are having problems too and wonder if you could give me any advise or if anyone on the board can help. I have been on Zoloft and Klonopin for 15 years and NEVER increased my dose. I have always been afraid to take more of either because I did not want to abuse them. I hope and pray you are doing better. One thing I have learned, if you have your health, INCLUDING mental health, you have everything! Thanks!

Edited by tiredofpanic50, 07 April 2008 - 09:25 PM.





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